Is Prep the same as PEP

[butfullplease]

As Prep isn't available in Australia except if you have a + partner, is PEP a workable option. if i went onto PEP would it have the same protection as Prep for the month I was on it?

[seaguy]

No PrEP is pre exposure PEP is post exposure here is a good explainer of the two http://www.aidsmeds.com/articles/HIVtests_12371.shtml

[fillmyholeftl]

Not necessarily..Research & protocols were developed for the specific purposes

As Prep isn't available in Australia except if you have a + partner, is PEP a workable option. if i went onto PEP would it have the same protection as Prep for the month I was on it?

[bearbandit]

I wouldn't say that PEP is a workable option because PrEP uses drugs with the lowest side effect profile possible, while maintaining a barrier against HIV. Even so, of the two drugs in truvada, one of them can cause serious liver damage in people with HIV (people without HIV seem to have a better chance against these side effect, possibly because of better initial health when starting them).

PEP involves a fairly intense period (usually four weeks) of therapy in which the virus is hit every which way because when people go for PEP it's already had time to establish itself - three days after exposure it's worthless. One of the biggest jobs I have at myHIV is persuading people who've just started HIV therapy (which, essentially, is what PEP is) to stick it out over at least the first month before they ask change combinations. While most of us with HIV get used to the side effects, and indeed end up not having any side effects as our bodies adapt, the fact remains that the drugs used for PEP can make you bloody sick.

Experienced as I am with ARVs (the health trainer at the charity I volunteer for calls me a drug whore since I've had most of them at one time or another) I've never yet met a combination that doesn't have at least some start-up side effects. Most are slight, but for PEP they bring out the big guns. You don't want to put yourself in line of fire, believe me!

[asianbtm37]

Based on my recent start of Truvada PrEP, I got an idea from medical professions that they use Atripla (Truvada+1) for PEP for 1 months. For PrEP, Truvada alone seems to be the current protocol. Before starting PrEP, same day result available DNA screening of HIV virus must be conducted showing negative.

Here in Tokyo, I found out horrifying public health policies and practices on HIV upon relocation. I flew out overseas where reliable generic medicines were available in South East Asia and got on PrEP after seeing several docs and having proper screening. The rest - cost of generic version of Truvada for a day is cheaper than a bottle of drinking water or a condom.

There is not even PEP access here Japan for general public!

Even if you have access to PEP in Australia, revisiting those clinics monthly doesn't sound promising option.

If you are interested in knowing how I managed to do it, privately email me. I will try my best answering how I got on with minimal cost and hassles.

If you are in generally good health, and have a recent full blood test result, that should be sufficient to avoid complications with Truvada.

[bearbandit]

one of them can cause serious liver damage in people with HIV

I meant Kidney damage - many apologies! I've lived with liver damage for so long that it's automatic to say liver damage, even when it's not. Sorry, guys!

[Guest JizzDumpWI]

bearbandit, what caused the liver damage?

[bearbandit]

Hepatitis B (didn't even enjoy getting it: it was a courtesy fuck - I mean, what else do you do when last night's trade's partner turns up?), followed by a number of imperfect, overdosed first generation ARVs.

Newly diagnosed guys take note: the same sort of damage will not happen to you if you opt for meds. There are alternative drugs available if it proves that you can't tolerate drug X, and doctors are keen to minimise the effects of ARVs on the body as damage to internal organs makes it harder to come up with an alternative prescription and their job is to heal not damage. We took the imperfect drugs because they were better than nothing: the same drugs that damaged my pancreas to diabetic levels also kept me alive till something better came along. I know guys who are into their third or fourth combination before their first year as a PwHIV is up because they couldn't find a good match. That said, side effects are unusual these days...

[Poz1956]

The recommended drugs for PEP vary depending on your location. Retrospective studies have shown no difference between two and three drug PEP. Some jurisdictions take a heavy and hard approach to PEP. For example, the province of British Columbia in Canada uses a four drug regime. The Australian PEP guidelines discuss both two and three drug protocols.

Since their two drug regime recommendation is for two NRTI class antretrovirals, I suspect Truvada would be the combo pill they most often use. For a three drug combination the guidelines specifically recommend against using an NNRTI, so Atripla would not be a choice used in Australia. (The side effect profile of Efaiarenz is high, so I doubt it is often used for PEP anywhere.)

I think you'll need to get your "story" together before you present at an ER for PrEP. It was a random hook-up, you met on a beat & you don't know how to get in touch with him (otherwise they'll want to bring him in for consultation and testing). You'd get a one week supply, & need to attend a follow-up session to get the rest.

Expect a little more counselling when you go for round 2 and 3, because the guidelines say "Those who present for repeat NPEP should be supported, with each presentation assessed on its merits. Such presentations show a need for education and counselling and assessment of predisposing medical, psychological and social factors."

There looks to be three PrEP demonstration projects starting in Queensland, NSW, and Victoria. The Victoria one only has room for 100 people. If possible see if you can get on one of those trials.